Philosophy of Medicine: normative and naturalistic approaches

Book (Korean): Philosophy of Medicine: Normative and Naturalistic Approaches. by Jongduck Choi. CIR Press/Korea, (Jul. 20. 2020)

Foreword1: James Marcum (Prof. of Philosophy at Baylor University, USA)
Foreword2: Kang, Sinik (Prof. of Medical Humanities at Busan University, Korea)
– What is the philosophy of medicine?
– Concept-maps to find methods of medical thinking
– Thinking maps in this book
– Questions asked by the Philosophy of Medicine
Reading manual

Chapter 1 The contemporary debates on the philosophy of medicine
1 “Does the philosophy of medicine exist?”: Critical answers
1.1 The philosophy of medicine would exist in the future
1.2 The peculiarity of the philosophy of medicine
2 Medicine as a moral enterprise: Pellegrino’s arguments
2.1 Relationship between medicine and philosophy
2.2 Philosophy of Medicine: Part and whole at the medicine
3 Scientific medicine : the biomedical model
3.1 Brief history of biomedicine model
3.2 The science-based biomedical model
3.3 Gorovitz and MacIntyre’s unassuming science of medicine
4 Humane medicine
4.1 Meaning of humanism in medicine
4.2 Charon’s narrative medicine
4.3 Marcum’s humane medicine
5 Holistic model
5.1 Cunningham’s model
5.2 Cassell: feeling and measurement
6 Value related medicine
6.1 Forstrom’s autonomous medicine
6.2 Munson: the patient isn’t analytical object
6.3 Medicine as an interpretive practice
7 Medical humanism
7.1 Medical humanities, its definition, and scope
7.2 Misunderstanding on the humanism for medicine
7.3 The future of the medical humanities
8 Mirror of the philosophy of medicine

Chapter 2 Medical inferences, causality, and medical artificial intelligence
1 Medical inferences
1.1 hypothetical deductive method and inductive method
1.2 Logical inference and circumstantial inference
1.3 Linear causal inference and multi-causes inference
1.4 Immediate direct cause and indirect cause
2 The causal inferences in clinics
2.1 Causation, association, and correlation
2.2 Hill’s criteria for causation in epidemiology
2.3 The character of evolutionary causes
3 Diagnostic inferences and judgments
3.1 Diagnosis and knowledge
3.2 Diagnostic reasoning
3.3 Pathophysiological reasoning
3.4 The evidence-based medicine; EBM
3.5 Procedure of diagnosis and its errors
3.5.1 The ladder of diagnosis
3.5.2 To avoid fallacious reasonings
4 Epidemiologic inference
4.1 Inferences at the case-control study and cohort study
4.2 The epistemological character of risk factors
4.2.1 Instance: smoking and lung cancer
4.2.2 Instance: lipid hypothesis
4.3 Risk factors based inference
5 Medical heuristics
6 Medical artificial intelligence
6.1 Development of knowledge engineering in medicine
6.2 The kinds of AI-inference
6.3 Logical base of a medical algorithm
6.3.1 Artificial Neural Networks; ANN
6.3.2 The structure of the artificial neural networks
6.3.3 Back-propagation, weights, convolution, and adversary
6.4 Medical applications of AI
6.4.1 Further uptakes of Generative Adversarial Networks
6.4.2. General applications of AI in medical practice
6.5 Philosophical reflections on the AI

Chapter 3 Nosology and medical realism
1 Ontological foundation of nosology
1.1 Classification and logic
1.2 Metaphysics as ontology
1.3 Platon, Aristoteles, and Aquinas, their nub
1.3.1 Realism
1.3.2 Essence
1.3.3 Substance
1.4 Essentialism in species and classification
2 De Buffon’s nominalism
3 Disputes over medical realism
3.1 Scientific and medical realism
3.2 Anti-realism: instrumentalism and constructivism
3.3 Stempsey’s value-dependent realism
4 19-century science and the rise of modern medicine
4.1 Medical pluralism
4.2 Duplexity of the 19-century science
4.3 Duplexity of the 19-century medicine
4.4 Classification as a tool of medical epistemology
5 Modern classification of diseases
5.1 Medical definition of classification and nosology
5.2 Philosophical scenery of classification concepts
5.3 Instance: classifications of mental disorders

Chapter 4 Disease concepts, their history, and models
1 Disease as a black box
1.1 Disease as a black box
1.2 Relationship between health and disease
2 History of concepts of disease
2.1 Hahnemann’s concept of disease
2.2 Bernard’s experimental medicine and his physiology
2.3 Canguilhem’s qualitative concept of disease
3 Diverse Models for understanding concepts of disease
4 Biomedicine as a scientific model
4.1 Biomedical view of disease
4.2 Boorse’s biostatistical theory, BST
4.3 Criticism against the BST
5 Sociocultural perspectives
5.1 Normativist concept of disease
5.2 Sociocultural view of disease as a metaphor
6 Disease, illness, and sickness: existential experiences
7 The intersection of the biomedical model and the humanistic model

Chapter 5 Illness and health from the perspectives of the medical anthropology
1 Approaches of the medical anthropology
1.1 Definition and branches of the medical anthropology
1.2 Winkelman’s psychophysiological symbolism
1.3 Different issues of the medical anthropology
1.4 The medical ecology
2 An anthropological approach to the placebo effect
3 Endemics and eco-syndemics
4 Ethnomedicine
4.1 Quinlan’s ethnomedicine
4.2 Cross-cultural ethnomedicine
4.3 Culture-bound syndrome
5 The salutogenic model
5.1 Antonovsky’s salutogenic paradigm
5.2 Developmental origins of health and disease (DoHAD)
5.3 Lifecourse health development(LCHD) model
6 Meaning of health in public health models

Chapter 6 Historical relation between Darwinism and medicine
1 Origin of Species and evolutionary theories
1.1 Lamarck’s evolutionary thought
1.2 Charles Darwin’s evolutionary theory
1.3 Medical educations in Darwin’s day
1.4 Spencer’s reinterpretation of Darwinism
1.5 Social Darwinism perverted as eugenics
2 Social Darwinian medicine’s view of body: from 1880 to 1940
2.1 Social Darwinian medicine differ from modern evolutionary medicine
2.2 Its view of disease
2.3 Its social mistakes
2.4 Its dissipation
3 The social challenges against Darwinism
3.1 Darwinism ousted from medical schools on early 20th Century
3.2 Neo-Lamarckian rise, eugenics

Chapter 7 Evolutionary medicine I
1 Backgrounds of evolutionary medicine
1.1 The historical backgrounds of evolutionary medicine
1.2 The biological backgrounds of evolutionary medicine
2 The foundation of evolutionary medicine
2.1 Basic references for evolutionary medicine
2.2 Epistemology of evolutionary medicine
2.3 View of disease in evolutionary medicine
2.4 View of body in evolutionary medicine
2.5 Methodological perspectives of evolutionary medicine
3 Evolutionary causes of diseases
3.1 Trade-off character of traits.
3.2 Imperfect compromise: vulnerability
4 Diverse interpretations of evolutionary medicine
4.1 Mismatch theory
4.2 Greaves: Science including evolution
4.3 Zampieri: disease of civilization
4.4 6 evolutionary models for human disease
5 A dispute over the paleolithic icon of health
5.1 Paleolithic body
5.2 Neolithic changes
5.3 Difference between paleolithic diet and the modern diet
6 Evolution of body and cultural change
6.1 Archeological view on the mismatch hypothesis
6.1.1 Developmental view of mismatch
6.1.2 Structural view of mismatch
6.1.3 The hygiene hypothesis
6.2 Thrifty genotype hypothesis
6.2.1 Neel’s thrifty genotype hypothesis
6.2.2 Is there a really thrift gene?
6.3 Grandmother hypothesis
6.4 Instances: red meat, increasing of cancers, menarche
7 A spectrum of the evolutionary medicine

Chapter 8 Evolutionary medicine II
1 Barker’s thrifty phenotype hypothesis
1.1 From thrifty gene hypothesis to thrifty phenotype hypothesis
1.2 Gluckman’s interpretation: DP/PAR
2 Evolutionary epidemiology of infectious diseases
2.1 Ewald’s evolutionary epidemiology
2.2 Interpretations of symptom
2.3 To Domesticate symptoms
2.4 Virulence of symptom
2.5 Gene’s-eye view of symbiont transmission
2.6 Non-anthropocentric evolution of infectious diseases
3 Critical opinions for the evolutionary medicine
3.1 Restrictive adaptationism
3.2 Evolutionary path and period
3.3 Evolutionary medicine in perspective of Evo-Devo
3.4 A Criticism that the adaptation is not an almighty
4 Reasons why evolutionary medicine could not enter into clinics
4.1 Causality in the evolutionary medicine
4.2 Collision and link between evolutionary medicine and clinics
4.3 A medical education, introducing of evolutionary medicine

Chapter 9 Philosophy of immunological medicine
1 Philosophical reflections on the immunology
1.1 Ontology of Immunology
1.2 Epistemology of immunology
1.3 Burnet: self and nonself
1.4 Immunological specificity, memory, and tolerance
2 Immunological disorders: instances
2.1 Autoimmune diseases
2.2 Antimicrobial resistance
2.3 Evolutionary dynamics of immunological disorders
3 Hygiene hypothesis based Immunology
3.1 Eradication or coexistence
3.2 Coevolution, symbiosis, and commensalism
3.3 Hygiene hypothesis and type of parasite
3.4 Philosophy of self-protection
4 On adversary mutations
4.1 Characters of mutation
4.2 Mutation rate
4.3 Numbers game
5 Parasite-centered strategy
5.1 Pathogen and antibiotic
5.2 Fight against host
5.3 Survival strategy: evasion, suppression, and neutralization
5.3.1 Evasion
5.3.2 Suppression
5.3.3 Neutralization
6 Instance: HIV
6.1 Protection principle and countermeasure of HIV
6.2 AZT deceiving virus
6.3 Virus’ mutation against AZT
6.4 Multidrug resistance: evolutionary ontology
7 Naturalized coexistence, its philosophical meaning
7.1 Philosophy of change, immunological ontology
7.2 Immunological ecology and commensalism

Chapter 10 From anti-aging medicine to medicine of aging
1 Desire and alienation
1.1 Medical triangle: Science, existential self, and society
1.2 Continuum of life and death
2 Cultural species and natural species
3 Aging: genetic cause and environmental cause
4 The telomere theory of aging
4.1 The Hayflick limit
4.2 End replication problem of telomere
5 Calories restriction, sestrins, and reactive oxygen species
6 Aging as an apoptosis
6.1 The mechanism of apoptosis
6.2 Apoptosis in the case of cancer
7 Evolutionary interpretations of aging
7.1 Aging and development of trade-off
7.2 Evolutionary ecology of the cancers
7.3 Evolutionary theories of aging: Hamilton, Williams, and Stearns
8 Developmental path and Epigenetic aging
9 Philosophical implications of aging
9.1 Two layers of aging: linkage relation and counter relation
9.2 From anti-aging medicine to medicine of aging
9.3 A philosophy of aging

Chapter 11 Science and philosophy in medicine
1 Analytical medicine and hermeneutic medicine
2 Explanation and Understanding
3 Philosophy of understanding: hermeneutic medicine
4 Medical phenomenology
4.1 Noema and Epoch
4.2 “87, Too Old For What”
5 Marcum’s phenomenological model of the body
6 Philosophy of medicine as a platform to approach to medicine


James A. Marcum (Professor of Philosophy at Baylor University, USA)

Philosophy of medicine, apart from medical ethics and bioethics, has become a vibrant academic field. Jongduck Choi’s Philosophy of Medicine: Normative and Naturalistic Analysis is not only a welcomed addition to the field, but it also advances the field in significant ways. The book begins with addressing the nature of the relationship between philosophy and medicine through conceptual mapping, especially in terms of the various approaches to contemporary medicine, including the traditional biomedical model as well as the human and holistic medical models.

Choi then explores various causal inferences pertinent to clinical practice, ranging from the diagnostic to the epidemiological. He covers familiar territory, including Hill’s criteria of causation, pathophysiological reasoning, and evidence-based practice. He next turns to medical heuristics and then advances the discussion with respect to medical artificial intelligence. Specifically, he explores the development of medical artificial intelligence in terms of artificial neural networks along with the application of artificial intelligence to clinical practice.

Choi then discusses the ontological foundations of medical nosology, especially as it relates to the debate between nominalism and realism. He next turns his attention to disease conception and classification. Choi covers the historical ground of disease conception beginning with Hahnemann in the eighteenth century and traversing that ground to contemporary biomedical and sociocultural models, including the existential experience associated with the humanistic model. He then discusses the notions of illness and health from various perspectives of medical anthropology, such Winkleman’s psychophysiological symbolism, Quilan’s ethnomedicine, and Antonovsky’s salute-genic paradigm.

Choi next examines the historical relationship between evolution and medicine, beginning with Lamarck and then Darwin and then turns to the impact of social Darwinism on medicine, especially eugenics. Importantly, he provides a comprehensive exploration of contemporary Darwinian evolutionary medicine and addresses various issues facing it, such as the thrifty gene hypothesis, as well as the difficulties facing it with respect to its application in the clinic. Finally, he rounds out his discussion of contemporary evolutionary medicine with an examination of both anti-aging medicine and immunological medicine.

Choi concludes Philosophy of Medicine with a chapter on the roles of science and philosophy in exploring and understanding the nature and practice of medicine. In sum, his book is not only a welcomed addition to the field of philosophy of medicine; but, it also progresses the field in significant ways, as I have endeavored to show in this Forward. And, I am confident that it will become a useful resource for others working in the field—if not a classic.


previous page